IRTA1 and MNDA Expression in Marginal Zone Lymphoma: Utility in Differential Diagnosis and Implications for Classification

Am J Clin Pathol. 2019 Feb 4;151(3):337-343. doi: 10.1093/ajcp/aqy144.

Abstract

Objectives: To evaluate the clinical utility of immune receptor translocation-associated protein 1 (IRTA1) and myeloid nuclear differentiation antigen (MNDA) expression in the diagnosis and classification of marginal zone lymphomas (MZLs).

Methods: IRTA1 was examined using a novel RNA in situ hybridization assay and MNDA expression determined by immunohistochemistry in 127 small B-cell neoplasms, including 80 cases of MZL.

Results: IRTA1 expression was detected in 31 (42%) of 74 MZLs vs one (2%) of 43 other small B-cell neoplasms (P < .001). MNDA staining was positive in 51 (64%) of 79 MZLs vs 21 (45%) of 46 non-MZLs (P = .06). MNDA expression was particularly uncommon in follicular lymphoma (3/14, 21%; P = .003 vs MZL). There was no association between MNDA and IRTA1 expression and the presence of monocytoid cytology. IRTA1 expression was less frequent in cases with a diffuse growth pattern.

Conclusions: IRTA1 and MNDA are useful markers in the differential diagnosis of MZLs.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Differentiation
  • Antigens, Differentiation, Myelomonocytic / metabolism*
  • Antigens, Nuclear
  • Biomarkers, Tumor / metabolism*
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunohistochemistry
  • Lymph Nodes / pathology
  • Lymphoma, B-Cell, Marginal Zone / classification*
  • Lymphoma, B-Cell, Marginal Zone / diagnosis
  • Lymphoma, B-Cell, Marginal Zone / pathology
  • Lymphoma, Follicular / classification*
  • Lymphoma, Follicular / diagnosis
  • Lymphoma, Follicular / pathology
  • Male
  • Middle Aged
  • Receptors, Fc / metabolism*
  • Transcription Factors / metabolism*

Substances

  • Antigens, Differentiation
  • Antigens, Differentiation, Myelomonocytic
  • Antigens, Nuclear
  • Biomarkers, Tumor
  • FCRL4 protein, human
  • MNDA protein, human
  • Receptors, Fc
  • Transcription Factors